Recently, various progresses have been made in the treatment of the genitourinary malignant
tumors. Effectiveness of the
intravesical instillation of anti-
cancer agents and
biological reaction modifiers has been proved in the treatment and prevention of the superficial
bladder cancer. Among them, superiority of BCG is now attracting attention of all the urologists. For the invasive
bladder cancer, the M-VAC
therapy (the
combination chemotherapy of
methotrexate,
vinblastine,
actinomycin and
cis-platinum) has been found to be extremely useful. The multidisciplinary approach for the down-staging of the advanced
bladder cancer has been advocated around the world. As for the
prostatic cancer, that of the high stage is the main concern of the Japanese urologists, since the mass screening of the
prostatic cancer has not prevailed in Japan. The
LHRH agonists or the blockers of the
androgen receptor have been replacing the classic antiandrogenic treatment consisting of
castration and
estrogen administration to treat the advanced
carcinoma. On the other hand, the nerve-sparing total
prostatectomy has been recommended for the low stage
cancer by Walsh and associates to preserve potency. The
testicular cancer has been most effectively treated with the combined
chemotherapy. The PVB and VAB
therapy are well known in the world. Lately,
VP-16 (
etoposide) was found to be a useful salvage agent. The least advance has been made in the treatment of
renal cell carcinoma, although
interferon therapy or LAK cell adoptive immunotherapy appears attractive.